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PubMed2003

Case managers' attitudes to the physical health of their patients.

OBJECTIVE: To examine the attitudes and practices of case managers working in Area Mental Health Services (AMHS) towards the physical health of people with chronic mental illness. METHOD: Case managers at four AMHS in Melbourne participated in focus groups and completed a survey questionnaire. RESULTS: Case managers generally believed that mental illness, psychotropic medication and lifestyle factors contributed to the poor physical health status of their patients. Although many case managers attempted interventions aimed at improving physical health, there was inconsistency regarding the areas targeted. Preventive health measures were often neglected. Overall, there was a sense of pessimism around whether improved physical health was possible for people with chronic mental illness. CONCLUSIONS: Lack of coordination among health professionals and the health system may contribute to the poor general health of people with mental illness. Patients often have difficulty accessing general practitioners and the culture within the AMHS can exclude considerations of physical health. Case management should include aspects addressing the physical health issues of AMHS clients.

Attitude of Health Personnel↗
PubMed2004

Environmental health physics-50 years of progress.

Environmental health physics is an interdisciplinary field, involving study of the release, transport, and fate of radioactive material in the environment. Further, it addresses the interaction of humans with radioactive materials within the ambient (outdoor) environment and with the environments associated with modern technology and lifestyles. It also involves both naturally occurring and artificially produced radionuclides with the former generally being by far the highest source of exposure. In fact, doses from naturally occurring radionuclides are increasingly being used as a benchmark for the establishment of dose rate limits for people. Because of the pioneering work of early environmental health physicists, models exist today that can be used to assess the potential impacts of new nuclear facilities prior to their operation. In fact, these people represent the branch of the health physics profession who conducted environmental monitoring programs and performed the associated research studies that led to the identification of the principal radionuclides of interest, the major pathways and mechanisms through which they expose people, and the doses that may result from radioactive materials in the natural and technologically enhanced environments. One of their most important contributions was the identification and quantification of many of the key parameters that serve as input to such models. Monitoring of nuclear weapons development facilities used during and after World War II was the initial stimulus for the establishment of environmental health physics programs. Thereafter, these programs were expanded both nationally and globally, as a result of the atmospheric weapons testing programs of nations such as France, the People's Republic of China, the former Soviet Union, the United Kingdom, and the United States. Additional stimuli were provided by the development of the commercial nuclear power industry. Current environmental programs, particularly within the U.S., focus on decontamination and decommissioning of dormant facilities from these earlier defense and commercial programs. The range of the environmental health physics aspects of these activities is the subject of this paper. Presented at the end of the paper is a summary of some of the more important lessons that have been learned. As will be noted, this is an exciting field that will present challenges to health physicists for years to come.

Background Radiation↗
PubMed2005

Environmental health physics: 50 years of progress.

Environmental health physics is an interdisciplinary field, involving study of the release, transport, and fate of radioactive material in the environment. Further, it addresses the interaction of humans with radioactive materials within the ambient (outdoor) environment and with the environments associated with modern technology and lifestyles. It also involves both naturally occurring and artificially produced radionuclides with the former generally being by far the highest source of exposure. In fact, doses from naturally occurring radionuclides are increasingly being used as a benchmark for the establishment of dose rate limits for people. Because of the pioneering work of early environmental health physicists, models exist today that can be used to assess the potential impacts of new nuclear facilities prior to their operation. In fact, these people represent the branch of the health physics profession who conducted environmental monitoring programs and performed the associated research studies that led to the identification of the principal radionuclides of interest, the major pathways and mechanisms through which they expose people, and the doses that may result from radioactive materials in the natural and technologically enhanced environments. One of their most important contributions was the identification and quantification of many of the key parameters that serve as input to such models. Monitoring of nuclear weapons development facilities used during and after World War II was the initial stimulus for the establishment of environmental health physics programs. Thereafter, these programs were expanded both nationally and globally, as a result of the atmospheric weapons testing programs of nations such as France, the People's Republic of China, the former Soviet Union, the United Kingdom, and the United States. Additional stimuli were provided by the development of the commercial nuclear power industry. Current environmental programs, particularly within the U.S., focus on decontamination and decommissioning of dormant facilities from these earlier defense and commercial programs. The range of the environmental health physics aspects of these activities is the subject of this paper. Presented at the end of the paper is a summary of some of the more important lessons that have been learned. As will be noted, this is an exciting field that will present challenges to health physicists for years to come.

Background Radiation↗
PubMed1998

Preliminary development of a scale to measure attitudes regarding the importance of role modeling in physical activity and fitness behaviors among Health, Physical Education, Recreation, and Dance professionals.

This paper presents a new 16-item scale designed to measure attitudes regarding the importance of role modeling in physical activity and fitness behaviors among Health, Physical Education, Recreation, and Dance professionals. The measure was reviewed for face validity by a panel of experts and preliminary analyses gave as Cronbach alpha of .95 and split-half reliability of .97 for 22 graduate students.

Attitude↗
PubMed1995

Recognition of emotional distress in physically healthy primary care patients who perceive poor physical health.

This study examines the recognition and treatment of emotional distress in physically healthy primary care patients who perceive themselves to be in fair or poor physical health. Patients (N = 892) from three private primary care practices completed a mental health screening form prior to their medical visit which included an overall assessment of their physical health (1 = excellent, 2 = good, 3 = fair, 4 = poor). Following the visit, their physicians completed a questionnaire that included the same physical health assessment item. The study group, physically healthy patients who perceive poor physical health (HPPPH), included those patients who rated their physical health as 2 or 3 points more impaired than it was rated by their physician. HPPPH (N = 39) were significantly more likely than other patients (N = 853) to report a prior psychiatric hospitalization (p < 0.05), marital difficulties (p < 0.01), recent missed work due to a mental health problem (p < 0.001), and a range of anxiety, depressive, and psychosomatic symptoms. However, HPPPH were also significantly more likely than other patients to receive excellent emotional health ratings (p < 0.001) from their physicians and were less likely to receive mental health treatment (p < 0.05). Detection of emotional distress may be particularly difficult in physically healthy patients who have low physical health perceptions. Identification of pessimistic physical health perceptions may serve as an indicator for underlying emotional distress.

Adolescent↗
PubMed1999

Quality of life in systemic lupus erythematosus patients during more and less active disease states: differential contributors to mental and physical health.

OBJECTIVE: To identify determinants of mental and physical health as a function of disease state in patients with systemic lupus erythematosus (SLE). METHODS: A sample of 129 SLE patients (mean age 42.01 years; SD 11.09) was recruited from 9 immunology/rheumatology clinics across Canada. Patients completed questionnaires assessing psychological distress, social support, coping, stress, and health-related quality of life. Physicians rated disease activity (using the revised Systemic Lupus Activity Measure; SLAM-R) and damage (using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index). Mental and physical health composite scores were derived from the Medical Outcomes Study Short Form 36. Patients were subdivided into more active (SLAM-R > or = 10; n = 38) or less active disease states (n = 91). RESULTS: Better mental health was predicted by more education and less emotion-oriented coping in the patients in a more active disease state (P = 0.0001; R2 = 0.46). Better mental health was predicted by less stress, less emotion-oriented coping and more task-oriented coping in patients during a less active disease state (P = 0.0001; R2 = 0.45). Better physical health was predicted by more emotion-oriented coping in patients in a more active disease state (P = 0.04; R2 = 0.11). Better physical health was predicted by less stress and younger age in patients during a less active disease state (P = 0.0001; R2 = 0.20). CONCLUSION: The positive association between emotion-oriented coping and better physical health in patients during a more active disease state suggests that this style of coping may be more adaptive in situations that are considered uncontrollable (e.g., SLE flare). Predictors of mental health were similar to those found in the literature, especially for SLE patients in a less active disease state.

Acute Disease↗
PubMed1988

Health status of Vietnam veterans. II. Physical Health. The Centers for Disease Control Vietnam Experience Study.

The Vietnam Experience Study was a multidimensional assessment of the health of Vietnam veterans. From a random sample of enlisted men who entered the US Army from 1965 through 1971, 7924 Vietnam and 7364 non-Vietnam veterans participated in a telephone interview; a random subsample of 2490 Vietnam and 1972 non-Vietnam veterans also underwent a comprehensive medical examination. During the telephone interview, Vietnam veterans reported current and past health problems more frequently than did non-Vietnam veterans, although results of medical examinations showed few current objective differences in physical health between the two groups. The Vietnam veterans had more hearing loss. Also, among a subsample of 571 participants who had semen samples evaluated, Vietnam veterans had lower sperm concentrations and lower mean proportions of morphologically "normal" sperm cells. Despite differences in sperm characteristics, Vietnam and non-Vietnam veterans have fathered similar numbers of children.

Adult↗
PubMed2005

Higher perceived life control decreases genetic variance in physical health: evidence from a national twin study.

Physical health has been linked consistently with both income and sense of control, and the authors previously demonstrated that genetic variation in physical health measures decreased with increasing income (see W. Johnson & R. F. Krueger, 2004). Using a nationwide sample of 719 twin pairs from the MacArthur Foundation National Survey of Midlife Development in the United States, in this study the authors show that genetic variation in physical health measures (number of chronic illnesses and body mass index) also decreases with increasing sense of control. The authors integrate findings for income and control by demonstrating an interaction between genetic influences on sense of control and income in explaining physical health. They hypothesize that the mechanism underlying the interaction is the known biological relationship between metabolic efficiency and adaptation to stressful environments.

Adaptation, Physiological↗
PubMed1995

The association of physical health and depressive symptoms in the older population: age and sex differences.

Physical health and depression are closely related in the elderly. This has been found in both cross-sectional and longitudinal studies. In this study the relation between four aspects of physical health and depressive symptom levels were studied in a community-based sample of older inhabitants of a small town in the Netherlands (n = 224). Results indicated that depression as measured with the CES-D is sufficiently different from physical health to be distinguished from it, and that it is sufficiently related to physical health to be relevant for further study. The more subjective measures of physical health used in this study (pain and subjective health) appeared to have a much stronger relation with depression than the more objective health measures (chronic diseases and functional limitations). Physical health and aspects of the social environment such as marital status appeared to have independent effects on mood. In this study these effects were moderated by age and sex. In women and the young-old (55-64) none of the associations between physical health and depression were significant. In men and the old-old (75+) all associations were highly significant.

Activities of Daily Living↗
PubMed2002

Health physics technician injury reduction.

As part of a safety summit sponsored by Fluor Hanford Occupational Health and Safety, it was noted that Health Physics Technicians (HPTs) have one of the highest injury rates at Hanford. A multi-disciplined team made up of HPTs, health physics professionals, health physics management, indostrial hygienists, and medical personnel was established to determine causes and corrective actions. Committee activities included reviewing and characterizing occupational injuries and illnesses, assessing areas affecting the health of HPTs, soliciting field input, performing field evaluations of tasks, and making recommendations for improvements to senior management. Five areas showed a need for immediate improvement: manmachine interface (human factors and ergonomics), work environment, procedures, people, and communications. A key area of risk identified is the lack of ergonomic design considerations of the survey instruments currently used. There are several cases of cumulative trauma disorder requiring surgery. These cases are directly related to use of health physics instrumentation and/or survey techniques. The committee has made ergonomics and instrument redesign/modification its key initiative for 2001. The committee is encouraging vendor support and is seeking feedback from other health physics organizations regarding their experience and any recommendations they would like to make. Some success has already been achieved through an ergonomics-training program aimed at all HPTs and their supervisors. In addition, there have been several changes made to the way surveys are conducted, survey frequencies have been reduced, and the way modifications have been made to existing instrumentation. This is a long-term initiative with broad support within the Hanford HPT community. This document reports the progress made thus far on the initiative.

Health Physics↗
PubMed1996

Traumatic events and physical health in a community sample.

The relationship of traumatic events to physical health was examined in a randomized community survey (N = 2,364) of Los Angeles residents, 16% of whom had experienced a lifetime traumatic event. This study tested hypotheses that individuals experiencing traumatic events have poorer physical health and that the negative impact of traumatic events on physical health is greater among disadvantaged sociodemographic groups. Regression analyses showed that respondents with a traumatic event history indicated poorer perceptions of their physical health, more chronic limitations in physical functioning, and more chronic medical conditions compared with respondents without such a history, while controlling for demographics, psychiatric history, and other stressful life events. The association of traumatic events with poorer physical health among vulnerable sociodemographic groups was partially supported.

Adult↗
PubMed1988

Education and training in health physics--a look to the future.

The next 15 to 20 y promise to be a challenging period in health physics education. The U.S. Department of Energy, in a review of current and projected labor market conditions for professional health physicists and health physics technicians, reports current shortages of professional health physicists in the civilian nuclear industry and predicts a high potential for shortages during the next 15 y. The academic health physics community is also faced with the following issues that compound the difficulty in meeting the high employment demands for qualified health physicists in the near future. (1). A decreasing number of programs--In the past few years, several programs have folded or have undergone reorganization, thus reducing the availability of quality programs to train health physicists and health physics technicians. (2). Decreasing federal funding--Government funding of health physics programs is limited, necessitating programs to obtain support from the private sector or from within the colleges and universities themselves. (3). Accreditation of programs--Should programs be accredited to standardize quality and program content? (4). Recruiting quality students--What can programs do to attract high-quality students into the health physics profession? In this paper, each of these issues is examined and possible solutions proposed. Our discussion is primarily meant to be provocative--in this way we hope to stimulate much-needed discourse as a first step in addressing and solving these problems which face the academic health physics community.

Education↗
PubMed2001

Association between physical health status with selected factors.

A study, to determine the physical health status of children between the age of three to five years and its association with selected factors, was conducted in a village of Udupi district of Karnataka state in 1998. The objectives of the study were to assess the physical health status of children between the age of three and five years, to identify the selected factors under study like employment status of parents, age of parents, educational status of parents, birth order of the child, number of siblings of the child, gender of the child, child care arrangements and socio-economic status of parents and to find out the association between physical health status of children between the age of three and five years and selected factors. The study used system's model. Co-relational survey approach was used and data were collected from 100 samples. Tools were developed by the investigator and purposive sampling was used for selection of sample elements. A significant association was observed between the physical health status of the children and the employment status of the mother [chi square = 4.003, p < 0.05], and no significant association was found between physical health status and age of parents, educational status of parents, birth order of the child, number of siblings of the child, gender of the child, child care arrangements and socio economic status of parents.

Chi-Square Distribution↗
PubMed1998

Wives, husbands, and daughters of dementia patients: predictors of caregivers' mental and physical health.

The purpose of this study was to investigate differences in and predictors of mental and physical health among wife, husband, and daughter caregivers of dementia patients using a stress and coping framework. The sample of 151 caregivers consisted of 55 wives, 43 husbands, and 53 daughters and was recruited from multiple community-based sources. Variables addressed were caregiver age, social position, years spent in caregiving, dementia severity, burden, worry, physical health, and mental health. Analysis of variance demonstrated gender-specific, kinship group differences in burden (F = 8.09, p = .000), worry (F = 6.287, p = .002), and age (F = 55.27, p = .000). Post hoc comparisons indicated that wives reported worrying most, while husbands were oldest and reported the least burden. Health predictors differed by group, with wives' mental health being predicted by severity of dementia, age, and worry (R2 = .16), husbands' mental health was predicted by burden and worry (R2 = .18); and worry was the only significant predictor of daughters' mental health (R2 = .33). Wives' physical health was predicted by years of caregiving and age (R2 = .10); husbands' physical health was predicted by age and worry (R2 = .24); and daughters' physical health was predicted by years spent in caregiving and burden (R2 = .27). Findings suggest that a stress and coping framework is a better predictive model for daughters' mental and physical health than for health of wives and husbands. Findings further indicate that different health-related nursing interventions may be required for different caregiver groups.

Adaptation, Psychological↗
PubMed1990

Nurses and shiftwork: effects on physical health and mental depression.

An examination was made of relationships between the physical health and mental depression of nurse shiftworkers and their scores on relevant social and work-related variables. Nurses on the day, afternoon, night and rotating shifts from five hospitals (n = 463) were surveyed using a mail-back questionnaire. Two alternative models were examined in the study. The first model suggests that shift work influences the physical health and mental depression of nurses, which in turn affect social and work-related variables including: family relations; formal and informal social participation; solitary activities; job performance; and job-related stress. Shiftwork's disturbance of the body's circadian rhythm would exert a direct affect on nurses' physical health and mental depression, which in turn would then affect other aspects of the nurses' lives. The second model suggests instead that shift work primarily affects social and work-related variables, which then influence physical health and mental depression. Circadian rhythm desynchronization, while still being a consequence of shiftwork, might not directly affect physical health and mental depression. Contrary to either of the two models proposed for the study, shiftwork was not found to be significantly related to either the nurses' physical health or mental depression. However, certain factors, when considered in conjunction with the unique shift-related job characteristics of nursing, may help to explain the study's unexpected findings.

Adult↗
PubMed1982

Trends in health physics salaries and employment: 1980.

A salary questionnaire was distributed to health physicists in July 1980 as part of the July 1980 Health Physics Society Newsletter and as a handout at the 1980 Health Physics Society Annual Meeting in Seattle. 752 responses were obtained over a span of 3 months. Mean annual salary was correlated with a series of variables including experience (time in the field), academic background, employer type, region, sex and licensure status. The data supported the following conclusions: (a) Mean annual salary for the health physics personnel responding to the survey was $29,400. (b) Individuals in the southeast and southcentral states had below-average salaries, whereas individuals in the northeast and Rocky Mountain states had above-average salaries. The difference between these extreme annual means was often in the range of 5000-$8000, and should exert considerable impact on recruiting success. (c) Industrial and consulting positions carry higher-than-average salaries, whereas academic and governmental positions tend to be somewhat below average. (d) Women in health physics are a small but growing minority which tends to have lower-than-average salaries. (e) Recent demand for trained health physicists seems to have caused starting salaries to rise somewhat more rapidly than continuing salaries, in general.

Employment↗
PubMed2005

The role of marital quality in physical health during the mature years.

OBJECTIVE: This study examined the role of marital quality in the physical health of mature adults. METHOD: Participants were from the National Survey of Midlife Development in the United States aged 50+ years who were in their first marriage. Five dimensions of marital quality and four indicators of physical health were used. RESULTS: Regression analyses indicated that marital quality indices accounted for a significant amount of explained variance in physical health. Most notably, higher levels of negative spousal behaviors uniquely contributed to physical health, predicting more physical symptoms, chronic health problems, and physical disability, and poorer perceived health. DISCUSSION: The occurrence of negative spousal behaviors was consistently associated with poorer physical health. The negativity effect observed regarding the costs and benefits of social support in general also applies to the context of marriage in that negative spousal behaviors outweigh positive spousal behaviors in contributing to mature adults' physical health.

Adult↗